Garment closure apparatus, system &amp; method

ABSTRACT

A versatile garment ( 18 ) which is a facsimile of normal clothing and which promotes personal well-being, privacy, modesty and euthermia, for use in the hospital environment or as required in the patient-care-giver interaction, which garment beneficially incorporates means ( 15 ) for versatile garment deconstruction prior to treatment or monitoring allowing patient access and incorporates means for post-treatment reconstruction of the garment in the post-treatment, diagnostic exam or monitoring environment.

FIELD OF THE DISCLOSURE

This disclosure relates generally to garments for patient use in themedical, surgical, therapeutic and/or diagnostic environment.

BACKGROUND OF THE ART

Although there have been significant advances in medical technology overthe past century, in-hospital patient garments, also styled as ‘garb’for the purposes of this discussion, have remained essentiallyunchanged. The original patient hospital gown designs were intended toprovide some theoretical practical solution for ease of access and useby medical and ancillary staff. Patient comfort and modesty and apatient centered design was not part of the remit. The over-ridingdesign criterion of existing garb is the desirability to easily removethe gown from the patient while the patient is unconscious,uncooperative or of limited mobility. Most conventional gowns arereusable and have a rear opening with posterior ties—making it difficultfor patients and care givers to remove. In addition, the patient isoften forced to wear two gowns, the second being tied in the front so asto cover their buttocks and back. This makes the task of access doublydifficult and negates the original design intentions of the garment. Thegarment itself, aside from leaving the patient semi-nude anduncomfortable, also fails to provide a familiar garment format thatpromotes maintenance of body temperature in the ambient hospitalenvironment. So, in summary, the current universal ‘garb’ fails to takeinto consideration inherent heat loss characteristics of a garment whichhas an open face across the majority of one of its long axes, therebyexposing the patient's skin to the ambient temperature of the hospitalenvironment whilst in addition, producing a negative psychologicalimpact to the wearer.

Changes to hospital practices and the increase in the use of disposableproducts for draping and gowning in the hospital or therapeuticenvironment have also failed to influence the design of hospitalgarments in either medical, surgical, therapeutic and/or diagnosticsetting or to change the basic premise of the hospital gown which isthat the patient's comfort is subordinated to the requirements of themedical, surgical, therapeutic and/or diagnostic environment.

The sole purpose of hospitals is to improve patient health care and oneof their continuing tasks and goals is to improve quality and deliveryof care while simultaneously reducing patient hospital days. Primaryobjectives include shortening patient stay, reducing hospital basedcomplications and morbidity such as infection and metabolic dysfunctionwhich have a negative effect on quality and delivery of care. The recenteconomic recession has resulted in significant budgetary cuts in Statecontributions to Health Care in the United States as well as in otherdeveloped systems such as the United Kingdom. The economic pressure todeliver more at less cost is paramount. Therefore the economic impact ofreducing patient days carries significant financial benefits. Theinventors observe that enhancing patient wellbeing and normalising theirbody temperature in the medical and hospital environment is of paramountimportance in positively influencing the patient's autonomic response,which is, in itself, a significant contributor to patient recovery andhospital stay.

The patient's immediate physical and psychological environment are asignificant element of the patient-care equation and the inventorsbelieve that the significance of improving patient garb design may haveunexpected and far-reaching consequences, extending to sustainedbeneficial homeostatic response and substantive improvement to thepatient's physiological and autonomic response recovery time.

The inventors perceive that existing garb serves to create two separateproblems for the patient, which their invention seeks to address: thefirst problem is psychological and the second physiological.

The instant invention therefore seeks to remedy the problems created byexisting garb through 1) amending the garment form such that it has thefacsimile of normal, everyday, clothing and 2) creating improved garmentfunctionality through the use of materials which have the requisiteinsulative and heat-retentive characteristics. Furthermore, the medical,surgical, therapeutic and/or diagnostic functionality of the garmentsshould favourably compare with existing garb, having equal or improvedutility in the hospital environment and allowing medical staffuninhibited access to various sites, as required, and accordingly thisis a complementary goal of the invention. Therefore the objective is thecreation of garments which are equally beneficial to both medical,surgical, therapeutic and/or diagnostic staff as well as the patient.This is contrary to the current status in which the garment is designedto be maximally beneficial to the caregivers only whilst in realityproving to be a encumbrance to them as well.

In summary, one facet of improving the patient's hospital and medical,surgical, therapeutic and/or diagnostic environment is the provision ofcomfortable, insulative, disposable, single-use, garb which is conduciveto the patient's modesty and which does not conspire to place them in areal or perceived physical or psychologically vulnerable situation.

The inventors believe that the inter-relationship between psychologicalstress and the resulting negative response of the patient's autonomicnervous system has been inadequately characterized. The patient'sadrenal response, which results from psychological stress, may be asignificant element in contributing to hypothermia in the ambienthospital environment. Clothing patients in alien, uncomfortable andforbidding garments contributes to psychological stress; therefore oneway of diminishing the adrenal response is through provision ofinsulative garments whose appearance conforms to more standard clothingdesigns and formats. There is a synergistic relationship between stressand hypothermia, each one aggravating the other.

The patient's psychological reaction to the alien and forbidding natureof the hospital environment creates autonomic responses to fear andphysical embarrassment which are counter-productive to optimal patientcare. A major component of the patient's response to the hospitalenvironment may be manifested by a subconscious adrenalin induced“flight-and-fight” response and the alien nature of traditional garb maytherefore be a contributor in causing adrenalin inducedvasoconstriction.

It is well known that adrenalin is a potent vasoconstrictor and thatperipheral vasoconstriction and redirection of the circulation to thebody core is a standard physiological response to stress. When combinedwith the inadequacies of a garb which leaves significant areas of thepatient's skin exposed to ambient air temperature, the ability of thebody to maintain a homeothermic environment is compromised and,especially in the pre-treatment environment, the patient is predisposedto hypothermia.

Hypothermic events in the hospital environment are classified as eithertransient or persistent. The definition for persistent hypothermia is areduction of core temperature to <36° C. for a period in excess of 24hours.

Inducing hypothermia in a mammal is relatively simple, however, itsreversal presents a significantly higher level of complexity. This isably summarized by Christensen, U. S. 2011/0172749; “Vasoconstriction ofthe peripheral blood vessels may arise under hypothermia in order toprevent further heat loss by limiting blood flow to the extremities andreducing heat transfer away from the thermal core of the body. However,vasoconstriction makes it much more difficult to reverse a hypothermicstate since vasoconstriction impedes the transfer of heat from the bodysurface to the thermal core and makes it difficult to simply apply heatto the surface of the body. This physiological impediment to heattransfer is referred to as a vasoconstrictive blockage to heatexchange.” For this reason it is preferable to prevent hypothermia,rather than attempting to correct for it in thepost-examination/diagnostic/surgical environment. The instant inventionhas the prevention of hypothermia as a principal objective.

Over the last decade, hospital induced hypothermia has been the subjectof many learned, technical publications. Without exception, thesestudies concluded that persistent hypothermia impaired innate immunesystem functionality, resulting in the development of sequelae such ascoagulopathy, increased incidence of wound infection and increasedmorbidity. Untreated persistent hypothermia was found to alsosignificantly increase the risk of death.

Conversely, heating the patient, correlates with an increase in bloodflow and oxygen tension at the tissue level, a reduction in infectionrate and a corresponding reduction in the requirement to useprophylactic antibiotics. Wherever statistics are quoted significantimprovements to patient recovery times result from the maintenance ofpatient core temperature. In summary, these benefits result inreductions in patient risk, hospital days and treatment complexity. Theforegoing confirms both the physical benefit to the patient and economicbenefit to the hospital system.

A significant proportion of the post-operative, recovery process effortis devoted to aiding recovery of the body core temperature. The processof restoring euthermia is by no means simple, and represents a timeconsuming, complex and sometimes contradictory environment whereindividual patient metabolic response varies considerably betweenpatients. Sub-optimal patient response can lead to prolonged patientrecovery time.

Existing intra-operative mechanical and electronic devices which areused to restore or prevent hypothermia are designed to apply heat to thetorso through provision of active heat mechanisms and additionalinsulative material layers. These layers are typically in addition toexisting medical garments and seek to restore euthermia, rather thanpreventing it. The inventors note that existing systems and methods alsoprovide significant practical difficulties in the hospital environment.The inventors therefore believe that providing garments with superiorinsulative properties is an effective means of preventing hypothermia.In the hospital environment this results in a simpler, more effectiveand versatile approach which yields significant physiological,psychological and financial benefits.

Existing Garment Format

Piraka, U.S. Pat. No. 7,181,773 “Hospital Gown” usefully summarizes thepractical and psychological drawbacks of existing designs; “The standardhospital gown has several drawbacks. One drawback is that the body areaswhich are generally considered “private areas” are exposed when they areuncovered for injections, suture removals, heart monitoring, telemetryhook-ups and feed line insertions. Exposure of “private areas”embarrasses many patients, particularly female and religious patients,and causes unnecessary stress.

Another drawback is that during many examinations and procedurespatients must be elevated or turned to release neck or waist ties andraise hospital gowns. Elevating and turning patients are not easy tasks,particularly when only a single nurse is available and patients areheavy and/or have limited mobility. In some cases examinations orprocedures are delayed until sufficient resources are available forlifting and turning patients. Another drawback is that elevating andturning patients causes discomfort in some patients. Still yet anotherdrawback is that large body areas are needlessly exposed tocontamination and infection.”

Prior art in the field therefore, proposes the use of a single piecegarment. In practice, the garment is impractical as there is no easy wayto partially disrobe the patient. The inventors perceive that thiscontributes significantly to accelerated patient heat-loss and theytherefore propose a two piece garment construction as being afundamental element of their invention.

Furthermore, prior art relies on garment closure via fasteners whichrequire either ties, buttons, single fastener specific point-to-point,or landing zone specific fasteners, all of which, the inventors note,present significant impediments to garment functionality.

The inventors conclude that making an exact alignment between male andfemale fasteners or between buttons and button-holes or aligning the twosides of a zipper is impractical when dressing a third-party especiallywhen the patient is unconscious, uncooperative or marginally responsive,and unable to assist, such as in the post medical, surgical, therapeuticand diagnostic environment.

Ties, buttons and point fasteners leave incomplete seams whichdiscontinuous securing means allow for significant reductions in patientcomfort and promote and result in undesirable patient heat loss. Theinventors note the inherent practical limitations of fasteners which aremanipulated using two hands, and observe that knots frequently presentunwanted, time consuming, complications when disrobing a patient. Knotsand buttons also leave open large areas of traditional garb resulting inunwanted heat loss to the patient. The most frequently used garmentscurrently in use, have ties which result in knots which pose problems inuntying often requiring cutting in emergency situations. Knots alsopresent an added hazard, creating a pressure point with resultant tissuenecrosis in the immobile, semi-mobile or uncooperative patient.

The practical difficulties of aligning snaps and re-adjustinggarment-fabric tensions which are encountered when re-clothing anunconscious or uncooperative patient, are further complicated whenpotentially bulky dressings have to be incorporated within the garment.Additionally, pressure required for re-attachment of the press-studs,may be considered undesirable, particularly in the vicinity of amedical, surgical, therapeutic and/or diagnostic site.

While hook and loop fastenings are generally accepted practicalsolutions to garment closure, the difficulties of re-fastening a singlecontinuous strip of hook and loop on a three dimensional shape such asthe human torso frequently results in incorrect or incomplete alignmentof the landing surfaces, which misalignment reduces the effectiveness ofthe attachments and can result in the undesirable possibility of thegarment inadvertently falling open, or being partially open, causingexposure of the patient and heat loss. There is also the added risk ofcreases and folds resulting from mis-alignment of closure which canserve as pressure points and potential hazards for snagging joints anddigits, with resultant injury. Hook and loop fasteners also have thepotential to abrade the skin in a patient who is unconscious or unawareof stimuli due to paralysis or diminished level of consciousness.Furthermore, the closure of a garment with non-continuous hook and loopfastenings promotes undesirable body heat loss which is detrimental tothe patient and therefore rejected as inadequate for the inventors'purposes.

Finally, the inventors observe that the use of zippers fails to deliverthe garment versatility which the hospital environment demands whileadding significantly to garment costs. Zippers have initial alignmentdifficulties, pose the risk of potential injury to skin and thefunctional limitation of closing the zipper either completely or not atall.

Therefore, the instant invention ideally removes the requirement toaccurately align mating fastener fixtures or surfaces which represents afurther significant practical benefit in the hospital environment,particularly when the patient is unable to assist in the process ofrobing or disrobing.

The fabric quality of garb which is equipped with traditional closuresmust have significant tensile and tear strength properties, such thatpremature failure at the point of fastening may be avoided. Prematurefailure of a fastening element renders the garment useless. Therefore,either the garment fabric must have inherently high tensile strengthproperties or be locally strengthened through the addition of gussets,folds, webs, material patches or other fabric strengthening features.These detailing features represent additional constructional complexityand incremental cost which the inventors intend to substantially reduce,or eliminate, in the instant invention.

Garments in use are traditionally one piece three quarter length withshort sleeves and are applied by placing on the patient from the frontand by tying once behind the neck and once at the lower back followed bya secondary overlap, if present, at the lower back with a third tie atthe side of the body. In addition, there is no convenient or simple wayto remove the garment or to disrobe the upper body whilst leaving thelower body covered.

Pants, if supplied, are made of transparent paper product withelasticated edges which achieve neither of their intended benefits whichis to cover the ‘private parts’ or to provide a comfortable lower bodygarment which also promotes heat retention. In the case of the pants,these are complicated to apply and remove, requiring the legs to beplaced through them and then be pulled up. This is a simple matter in astanding cooperative patient and a logistical nightmare requiring twocare-givers in the supine uncooperative patient. There is also no methodto remove the panties other than time tested method of tearing themapart. In addition the elasticated edges can abrade open wounds.

In contrast, the invention implicitly integrates the concept of a twopiece garment always allowing integrity of closure of the upper andlower halves of the body as separate identifiable goals withoutdetracting from the use of the upper body garment as being of variablelength depending on the needs and preferences of the care givers and thepatient.

Because of the versatility of the material, the possibility of addingdesign elements to the fabric such as patterns and colors should not beminimised, selecting different colors and patterns for male and femaleand selecting garments with cartoon prints for children etc., evenallowing for sponsorship and advertising on garments.

BRIEF DESCRIPTION OF THE INVENTION

The invention, takes the form of a two piece garment of traditionalconstruction: that is to say that, unlike traditional garb or prior artin the field it has no open or partially open seams, except for neck,arm and leg holes.

The garment for the upper body generally takes the form of ablouse/T-shirt and for the lower body, shorts or trousers.Alternatively, dependent on regional custom, a dress with short or longsleeves may be preferred. The patient's limbs may be partially or fullycovered, as required. For the lower limbs, socks may be incorporatedinto the garment. The dress may be of any length, waist upper thigh,mid-thigh or ankle length.

For Islamic countries a head dress may also be incorporated as aseparate or integrated attachment, with or without a facial cover.

The design format, construction and choice of garments for anindividual, can be altered to factor in the therapeutic needs of thepatient, the specific treatment area of the hospital, the ambient airtemperature, the patient's anticipated metabolic response and theproposed duration of the treatment.

The garment is constructed from fabric which may comprise one or morelayers, in order to formulate the appropriate structural, insulative ortextural properties, as may be required. Any fabric type, whether woven,knitted or non-woven may be used, however, preference, is given tocellulose based, disposable, single-use fabrics which are capable ofbeing recycled. The use of cellulose based fabrics results in reducedhandling, laundering, sterilization and storage requirements which hassignificant economic benefit.

The surgical and therapeutic utility of the garment is enhanced throughthe strategic placement of seams which are positioned such that sites ofspecific surgical interest can be exposed. The garment seams are largelypositioned along traditional lines, with the seams being stitched,glued, welded or attached by any other conventional or unconventionalmeans, as required. The versatility imparted by the seams is furtherenhanced by collaborative juxtaposition with fasteners which are used toclose the garment. Preferentially, the closure mechanisms should be ofcontinuous—as opposed to intermittent—construction so as to leave thegarment relatively air-tight, thereby beneficially reducing patient heatloss and protecting patient modesty.

In summary, rather than requiring site specific placement fasteningswhich require orientation and create a discontinuous junction in thegarment fabric, the instant invention improves over prior art throughthe preferential use of a re-sealable fastener which attaches directlyto the fabric, to form a continuous seam. By comparison with prior art,the re-sealing elements of the instant invention, do not require precisealignment of mating materials and therefore beneficially allow for minoralterations to the post-intervention fitting and accommodation of thegarment.

As a result of the types of closure which are incorporated into theinstant invention, tensile loading of the garment fastening mechanism isdistributed across the entire length of the separable seams, therebyavoiding point loading and resulting in the ability to reduce thetensile strength of the material as a whole. Preferably, inter-garmentstructural reinforcements may be dispensed with completely. A benefit ofbeing able to construct the garment with reduced material tensilestrength is the opportunity to construct utilizing different materialsand fabric properties than has hitherto been possible.

The garment may also be modified to incorporate active chemical heatinserts to provide active heating during interventions which carry therisk of excessive body loss and resultant hypothermia such as protractedsurgical procedures.

In summary, the instant invention improves the cosmetic appearance,quality, structural and insulative character of hospital garments addingsignificant and quantifiable benefit in increasing patient comfort andreducing recovery time, without increasing garment unit costs ornegatively impacting the therapeutic requirements within the hospitalenvironment.

DETAILED DESCRIPTION OF THE INVENTION

A detailed description of the invention now follows; the detaileddescription will, follow the structure, mechanisms and detail for thegarb and the person learned in the art will appreciate that thedescription contained herein is not intended to provide a constraint orlimitation on the design or deployment of the invention, but rather todescribe the features and benefits of the invention.

Therefore, the illustrations contained herein are intended to disclosethe key elements of the design. Persons skilled in the art willappreciate that the embodiments of the invention disclosed herein havebeen particularly described for the purposes of disclosing the inventionand it is not the inventors' intention to limit the invention to thedescribed embodiments, since other embodiments may be developed fromthis disclosure by persons skilled in the art.

FIG. 1 a is a schematic plan view of the front side of the presentinvention as configured with short-sleeved and short trouser-legs,illustrating potential configurations for placement of perforations.FIG. 1 b is a schematic plan view of the front side of the presentinvention as configured for long sleeved and long trouser-legs,illustrating alternative potential configurations for placement ofperforations. FIG. 1 c is a three-dimensional schematic showingplacement of opening seams on a side elevation.

FIG. 2 a shows an alternative configuration for garment fabricindicating enlarged perforations which act as place-markers andstop-perforations. FIG. 2 b illustrates the partial internalconstruction of a webbing strip used for closing garment seams which hascomparable features.

FIGS. 3 a to 3 c illustrates cross-sectional and isometric drawings ofan alternative configuration of the garment seam structure comprising apress-fit seam.

FIGS. 4 a, 4 b, and 4 c present cross sectional views illustrating oneconfiguration of the garment fabric and underlying web.

FIG. 5 a illustrates a cross-sectional view of the garment and closuresystem prior to deployment.

FIG. 5 b illustrates a cross-sectional view of the garment and closuresystem post deployment during patient treatment and FIG. 5 c illustratesthe garment re-sealed in the post-treatment environment.

FIG. 6 a illustrates an cross-sectional alternative configuration of thegarment closure system.

FIG. 7 a through 7 c: shows an alternative garment closure mechanism,particularly illustrating alternative structural configurations of theinternal closure mechanism to the opening seam.

FIG. 8 a illustrates the position of seams on one particular garmentconfiguration; FIGS. 8 b and 8 c illustrate webbing layouts and relativepositions on the garment, emphasising sectional capability and FIGS. 8 dand 8 e are cross-sectional illustrations of potential seamconfigurations.

Commencing with FIG. 1, the garment generally 10, is constructed fromfabric 11, which has an interior surface, 12 and an exterior surface,13. The interior surface 12, is proximate the patient's skin and theexterior surface 13, is exposed to the air. The fabric, 11, may beconstructed from any of a class of materials which have the desiredattributes of insulation, moisture wicking, elasticity, support andpermeability as may be required in order to create a suitable garmentfor the wearer. The insulative properties of the material 11 areselected based on a number of criteria; for example, the anticipatedambient temperature of the hospital environment; the duration of thesurgical or diagnostic or therapeutic intervention and the homeostaticcharacteristics of the patient. For example, in the case of an elderlypatient undergoing an operation of some duration and complexity, ahigher degree of corporeal heat retention may be sought, resulting inselection of a garment 10 constructed from fabric 11 with significantlyhigher insulative properties.

The material, 11, may be woven, knitted, or spun and may be formed fromnatural or man-made materials as required. Fabric threads may be coatedor be natural, according to preference and the dictates of regulatorybodies, as required. Wherever possible, it is the inventors' preferenceto utilize fabrics made from natural fibers which have the addedeconomic benefit of being both disposable and recyclable. A preferredmaterial 11 for the construction of the body of the garb is cellulosewhich may be manufactured with inherently heat-retentive quiltedstructures. Beneficially, cellulose materials are low-cost, commerciallyavailable, recyclable and have other desirable mechanical propertieswhich are of interest in the construction of the garment, 10.

Also, for example, fabrics which are constructed from the products ofbamboo are of interest. Such plants are fast growing and need little orno chemical intervention in terms of fertilisers or pesticides and aretherefore beneficial to the environment. In addition, fabric constructedfrom bamboo is known to have both wicking and anti-bacterial propertieswhich increases its attractiveness in the field of hygiene materials.

However, it will be understood that any type of fabric, whether man-madeor natural, coated or raw fiber, disposable or re-usable, may be usedwithout departing from the spirit of the invention.

Generally, for ease of construction, the garments 10, are symmetricalabout their longitudinal midlines, although this is not intended topresent a constraint on the design. The garb for the upper body 20 hasthe appearance of an everyday garment, complete with sleeves 21,neck-hole 22, and body 23. The upper body garment 20 may be alsosleeveless without departing from the spirit of the invention, butpreference is given to the incorporation of sleeves 21 for purposes ofretaining the patient's body heat. The sleeves 21 may be of any length,as determined by the ambient environment and patient specificrequirements and may further be equipped with elasticated cuffs 39 tofurther enhance retention of body heat. The key differentiator fromprior art in the field is that, as all of the major garment panels 17are continuously attached to adjacent panels 17, the patient's body 9 isnot exposed to the open air and therefore not subject to high levels ofbody core heat loss. Furthermore, the semi-fitted nature of the garb 10does not allow for a significant volume of air-flow between thepatient's body 9 and the ambient environment.

The garment for the lower body 30, takes the form or shorts 31 or,preferably, leggings 32. If the latter, these may be equipped with socksor bootees.

Although there is a simplicity in producing a garment from a singlefabric piece, in practice, the majority of garments are constructed frommultiple panels 17. Such multi-panelled garments lend themselves to moreconvenient and economically beneficial methods of constructing garb withseparable panels.

Another requirement is that the garments 10 provide medical staff witheasy and unfettered access to the patient which results in the garbbeing readily segmented. Therefore, the fabric 11 which is used in theconstruction of the garment, 10, is equipped with separable seams 15which are used to segment the garment 10. The separable seams 15 maycorrespond with seam locations used in traditional garment panelplacement, or, alternatively, may be specifically configured to suitparticular medical, surgical, therapeutic and/or diagnosticrequirements.

The utility of the garment 10 may be enhanced by placing the separableseams 15 so as to accommodate not only the site of intervention, butalso to create minor panel openings (not illustrated) which accommodatethe access requirements for ancillary equipment such as catheters,cannulae, biometric and telemetry units, which access points may belocated outside the immediate therapeutic site and which may requireboth upper and lower body garments 20, 30, to be opened in order toobtain more complete access to the patient 9. These sites, specifically,would be in the abdominal area for colostomy bags, or open abdominalwounds; in the perineal area for catheterisation of the urinary system,in the back shoulder, anterior and lateral chest for telemetry andcentral lines, in the extremities (ventral aspect of wrist, dorsum ofhand or foot, ankle, groin or ante-cubital fossa for intravenous,intra-arterial and central line access or in any other site-specificlocation as may be desired. This description is not designed so as tolimit the different configurations of the garment, since othertreatment, therapeutic or diagnostic procedures may require exposure ofany part of the body e.g. ultrasound examination of an abscess,Wound-Vac™ management of an open wound, mammography, etc.

An additional requirement and advantage of the garment 10 is that itshould not be radio-opaque or in any way interfere with MagneticResonance Imaging or Computer Assisted Tomography or Radiographicprocedures. However, no limitation is intended by this statement as tothe potential for inclusion of radio-opaque panels, such as in the areaof the reproductive organs.

The inventors conceive that different versions of the garment 10 may becreated, each having therapeutic or surgical site specific practicality,without departing from the spirit of the invention. Accordingly, theillustrations contained herein, illustrate embodiments of the inventionwhich embodiments are designed to accommodate medical, surgical,therapeutic and/or diagnostic intervention on the torso or extremities,as required.

Therefore, the seam boundaries 15 may be of any length or positioned inany position on the garment 10 which, by design, may be site-specificfor the treatment or diagnostic modality which is to be conducted. Theseam boundaries 15 may preferentially be opened through the use of linesof weakness which are formed within the fabric 11 of the garment. Onesuch configuration of single-use garment opening is the use ofperforations 15, which may be incorporated into the garments 10, in sucha manner as to run longitudinally, circumferentially, or diagonally withrespect to the patient's body, or in any orientation or combinations oforientations as desired.

For greater surgical versatility, for example, as illustrated in FIG.1A, a preferred configuration of the garment incorporates seamsseparable 15 along the patient's mid-lateral access 16, along thesuperior or caudal aspect of the shoulders 8, the axillary and medialarm area, 24 and also along a longitudinal midline 14 on anterior 18 andposterior 19 aspects of both upper 20 and lower garments 30. Thisconfiguration allows access to the torso for medical, surgical,therapeutic and diagnostic manoeuvres.

In an alternate long-sleeved configuration, which also provides coverfor the whole of the lower body, as illustrated in FIG. 1B, the garmenthas anterior 18 and posterior elevations 19 which are circumferentiallydivided into panels by separable seams 15 in the garment fabric 11 forexample, at mid-thorax level, 5 and at upper thigh 7 and knee levels 6for the purposes of allowing patient access to the torso for medical,surgical, therapeutic and/or diagnostic manoeuvres.

The position of the separable seams 15 is such that they operate eitherindependently or in collaboration, thereby creating greater garmentversatility. The creation of an opening 17 within the garb does not, ofnecessity, require the detachment of a garment panel 17 as the primaryintention is to fold the panels, exposing the site of intervention suchthat the panel opening 17 in the garb 10 may be closed after completionof the medical, surgical, therapeutic and/or diagnostic procedure.

Turning now to FIG. 2, the method of construction of the separable seams15 is such that the shear strength of the materials 11 which are used tobridge the interstices 37 between garment panels 17 is intentionallycompromised, resulting in the ability to manually dissect the seam 15,thereby allowing segmentation of the garment 10. The seam 15 should,however, be of sufficient strength that garment integrity is maintainedwhen the patient is putting on the garment 10.

The required reduction in tensile strength may be accomplished by anypracticable means, as required, for example, as partially illustrated inFIG. 1, and FIG. 2, through the use of perforations 25 formed within thegarment fabric 11, which effectively decrease the intra-fabricstructural strength, or as illustrated in FIG. 3 b, by constructing agarment seam 15 which is constructed by overlapping two panel sections17 a, 17 b and separable weakened junction 15 at the seam. FIG. 3illustrates one potential configuration which comprises adjacentcellulose garment segments 17 a, 17 b, which are overlapping and featurepressed or embossed 36 sections which are bonded so as to form aseparable seam 15. Alternatively, as illustrated in FIGS. 4 through 8, areduced shear strength joint 15 may be formed, for example, by creatingan interval of weakness within the fabric structure 11 along theprincipal seam axis 15 such that once the separable seam opening 15 hasbeen created, the separation of the seam 15 results in the creation oftwo adjacent fabric section margins 37 each located on two adjoining,but separated, garment panels 17.

Therefore, as illustrated in FIGS. 2, 4, 7 and most particularly, FIG.8, perforations 25 form intra-garment boundaries 15 which sectionalisethe garment into convenient panels, 17 allowing access for both medical,surgical, therapeutic and/or diagnostic equipment. Perforations 25 maybe of any diameter and spacing necessary to accomplish the goal ofreducing the strength of the fabric joint 15 without compromisinggarment structural integrity in the pre-treatment environment. Thismethod is particularly suited to garb constructed from cellulose pulpproducts such as paper. It will be understood by those practised in theart that the perforations described and illustrated herein areindicative of one particular embodiment of the invention and that anyshape, form, configuration or arrangement of perforations is consideredto be within the scope of the invention.

A further useful adaptation to the perforations 25 is illustrated inFIGS. 2 a, 2 b and FIG. 8 whereby larger diameter perforations 27 areused to more clearly define the marginal limits 37 of particular garmentpanels 17. Therefore these large diameter perforations 27 both act toprevent the uncontrolled run of perforations, providing tear-open limitsand serving to more clearly define panel 17 seam boundaries 37 for thepurposes of identifying the location of garment 10 re-sealing means 26,as will be explored later. FIG. 2 a illustrates the principle ofperforations 25 as applied directly to the fabric 11 itself,illustrating the resulting individual panels 17, and the separable seams15—in this configuration they are perforated, but any reduced strengthjoint may be used to achieve garment panel 17 separation. FIG. 2 afurther illustrates the use of enlarged perorations 27 as garment panelintersection 17 markers and—because the fabric pictured is stillintact—the potential resulting panel 17 margins 37.

FIG. 2 b, by comparison illustrates the principle of providing indirectgarment panel 17 perforation means, 25, via a fabric strip 47 which ismounted on the internal surface 13 of the fabric 11. The separate panelsof the garment 17 a, 17 b, 17 c, 17 d have been shaded to illustrate therelative positions of fabric strip 47 with respect to individual garmentpanels and also to illustrate the utility in defining individual garmentpanels 17 by co-location of the internal strip 38 across the margins 37of the separable panels 17. The implication here is that the practicalgarment construction remains concealed from the patient, as the panelconstruction means are within the garment structure. The garment panelmargins 37 are defined internally by the location of internallypositioned fabric strips 38, which panel sizes 17 may be of anydimension and located according to specific medical, surgical,therapeutic and/or diagnostic purposes, and that garb 10 can thereforebe customized to suit specific procedures. This feature is of benefitbecause the patient can be clothed in the gown and then the appropriatepanels 17 can be selected in order to expose the appropriate medical,surgical, therapeutic and/or diagnostic site, without unnecessarilyinducing unwanted patient heat loss. In FIG. 2 b, the internal fabricstrips 38 are attached to the panels 17 by means of stitching, 48,however, clearly any other attachment means can be used withoutdeparting from the spirit of the invention. Alternative cross-sectionalconfigurations of FIG. 2 b are illustrated in more detail in FIG. 7.

Conversely, as illustrated in FIG. 8, fabric strips 47 could be locatedon the outer surface 13 of the garment fabric 11. In This configurationhas some merit because it aids surgical staff in locating the requiredgarment openings. In exemplary FIG. 2 b, the panels 17 are co-located insuch a manner as to have adjacent edges 37, however, it may be desirableto have the margins 37 of the panels 17, overlap so as to provide bothgreater structural integrity and enhanced euthermic properties andclearly this is depicted in FIGS. 8 d and 8 e and also lies within thescope of the instant invention.

In an alternative arrangement, illustrated in FIG. 3, which removes therequirement for perforations to be made in the fabric 11 and which mayincrease the available range of materials used in the construction ofthe garment 10, the individual sections 17 of the garment are cut fromseparate pieces of material 11 which pieces are press-bonded together toform a draft-proof garment 10 seam 15.

FIG. 3 a through 3 c, therefore, illustrate both a sectional andisometric view of a garment seam 15 configuration. This may require themargins 37 of the fabric sections, 17 to be chemically treated so as togive the necessary adhesive and form retentive properties to bothsections 17. Therefore the margin of the garment 37 may be treated withadhesives, or starch or some form of stiffening in such a manner that,post manufacture, when the garment fabric 11 treatment is complete theshape of the embossed sections 36 is retained. By pressing the fabricsections 17 to form raised surfaces 36 a tensile bond between fabricsections 17 may be made which is sufficient to withstand everydayhandling, such as that which is encountered during dressing, but is notso strong as to create an impediment to hospital staff when disrobingthe patient.

The inventors note that any garment which is configured with panels 17has the potential to create undesirable heat loss in a patient 9. Theuse of perforations 25 as a means of sectioning the garment 10 resultsin unwanted exposure of the patient's skin 9 and presents the potentialfor heat loss. Therefore, as illustrated in FIG. 4, the garment 10 mayon the interior surface 12, of the fabric, 11 immediately beneath theperforations 25, preferentially be equipped with an internal fabricstrip, or web of material, 38.

The internal webbing strip 38 serves multiple purposes. Prior to thetreatment or intervention, it prevents patient skin 9 heat loss via theperforations 25. It may also replace the perforated boundary 15 fabricand be used to maintain garment seam 15 integrity prior to theoperation. It serves, therefore, as a logical boundary defining thelocation of the medical, surgical, therapeutic and/or diagnosticintervention and, finally it acts as a mechanism for post-treatmentre-connection of garment sections 17, being used to re-seal the openmargins 37 of the separable seams 15 in order to effect closure of thegarment panels 17 and re-form the garment post-operatively.

The fabric web 38, as depicted in FIG. 4, FIG. 7 and FIG. 8 d, has aninterior surface, 41 and an exterior surface 42. For purposes ofidentification, the interior surface 41, of the fabric web 38, is thesurface which is in closest proximity to the patient's skin 9 when thefabric strip is being used as a garment 10 closure means. The fabric web38 is assembled within the garment 10 such that it runs coaxially withthe separable seam 15 boundaries 37, bridging the axis of separable seam15, in such a fashion that a continuous, draught-proof, seamconstruction 15 is created, thereby reducing convective and radiativepatient heat loss. The web 38 is therefore connected so as to runcoaxially, parallel to the separable seams 15. Despite the requirementfor continuity at the seam boundaries 37, nothing prevents the use ofmultiple sections of internal fabric strips 38, as illustrated in FIGS.2 b, and 8 a through 8 c, in order to improve the versatility of thegarment 10 construction. For preference these sealing strips 38 arefeatured so as to conveniently overlap the garment panel margins 37,creating air-tight garment panels 17 without creating significantadditional bulk in the garment 10 construction.

The internal fabric strip 38 as illustrated in FIGS. 2 b, 4, 7 and 8 dand 8 e, is preferentially permanently attached 43 parallel and adjacentto one margin 37 of a garment panel 17, in a continuous fashion. Thepermanent connection 43 means may be selected from a group ofconventional or non-conventional fabric fixing methods, i.e. asillustrated, by stitching. However, gluing, laser bonding or any othermethod or combination of methods which are determined by the choice ofgarment fabric 11 and the required bond strength between internal fabricstrip 38 and garment fabric 11, may be selected, as required. Thecentral portion of the strip, 29 however, remains detached from theinner surface 12 of the fabric, 11.

As illustrated in FIG. 4 a, for the improved comfort of the patient andto avoid transit damage to the sealing web means 38, a second, optionalattachment 44 of the internal fabric strip 38, using temporary bondingmeans 44 to affix the un-attached margin of the fabric web 38 to theinner surface 12 of the fabric 11 of the adjacent panel 17 may be made.This temporary attachment 44 may be dispensed with entirely, as in FIG.4 b, if the material characteristics of fabric 11 and web 38 allow forthe web 38 to structurally self-support across the junction 15 betweentwo adjacent garment panels 17.

FIG. 4 a therefore illustrates a cross section of the internal fabricweb strip 38 and the garment fabric 11. The web 38, has two, continuousaxes of attachment, 43, 44, running parallel to the garment panelmargins 37, which panel margins are created by separable seam 15 orperforated boundary 25 within the garment fabric 11. The construction ofeach of these internal web strip attachments is different. One of theattachments 43 is designed to be permanently attached to the innersurface 12 of the garment fabric 11. The opposite margin of the internalfabric strip 38 is affixed using detachable means 44 to the innersurface 12 of the garment fabric 11: that is to say the shear strengthof the temporary attachment method 44 which is used to attach thewebbing 38 to the interior surface 12 of the garment fabric 11 isinferior to the tensile strength of the fabric 11 which is used tocreate the garment 10. This, results in a webbing strip 38 which iscapable of selective detachment from the garment 10. In a garment whichis configured with perforated seams, 25 preferentially the webbing 38 isaffixed to the interior surface 12 of the fabric 11 such that itdetaches from the inner surface 12 of the garment 10 simultaneously whenthe separable seams 15 are detached.

Self-evidently the garment 10 could be constructed which had the optionof both internal fabric strip 38 margins being detachable, and this isconsidered to be within the scope of the invention, however, theinventors observe that, potentially, this would create additional workfor the hospital staff in terms of determining which web margin 38 toleave connected to the garment 10 and result in unnecessary complexityconcerning the selection of panel closure means to be used in thepost-treatment environment. Therefore, by having one margin of the web38 permanently attached, garment mis-application issues andcomplications are thus avoided.

Therefore, when the garment 10 is in use, the separable seam 15 isopened, revealing the inner fabric strip 38: at this point in theprocedure, as illustrated in FIG. 4 a, the garment 10 still encompassesthe patient's torso 9. The temporary adhesive strip 44 which connectsthe web 38 to the inner surface 12 of the fabric 11 by low shearstrength glue, or by other suitable means, is detached, thereby exposingthe patient's torso 9. The resulting garment sub-sections 17 are thenfolded back, revealing the site for treatment modality and allowing theprocedure or monitoring to be carried out. In manufacturing thedetachable margin 44 of the internal fabric web 38 preference is givento the use of reusable tack adhesive glue which is capable ofre-attachment and which is commonly used for re-attaching cellulose orpaper goods, although clearly any manner of adhesive can be used.

In FIG. 4 b, an alternative configuration is shown whereby the fabricweb 38, although overlapping the separable seam boundary so as to createa draught proof seam, remains substantially and permanently attachedonly along a single margin 43. In configuration, FIG. 4 a, on detachingthe perforations 25, the bond between web 38 and adhesive section 44becomes the weak element in retaining connectivity between the twomargins 37 of the now separable garment 10 and when detached, allowshospital personnel access to site for treatment modality. In theconfiguration illustrated in FIG. 4 b, once the perforations 25 aredetached, the entire garment is immediately open, allowing access to thesite of treatment. Whichever garment configuration is adopted, eitherFIG. 4 a or 4 b, FIG. 4 c illustrates the post interventionconfiguration. In FIG. 4 c, the temporary adhesive strip 44 is securedto the outer fabric surface 13 of the garment fabric 11, thus providinggarment closure means.

In the post intervention mode, illustrated in FIG. 4 c, the garment 10is closed, covering the patient's skin 9, thereby preventing additional,unwanted heat loss. The temporary adhesive strip 44 is configured eitherby means of using reduced strength glue or by altering the adhesiveproperties of either or both of the exterior surfaces of the fabric 12or the interior surface 41 of the fabric web 38, or by altering thestrength of the adhesive, or by some combination of these factors. It isimportant, from a practical perspective, that the re-attachmentmechanism 45 remains inactive until the procedure is completed and thereis a requirement to close the garment 10. This may be accomplished by anumber of means, including having a “tear-off” protective strip 46, asillustrated in FIGS. 4 b, 7 b and 8 d, which controls access to theadhesive layer, or by varying the properties of the garment fabric 11along specific margins which are to be used for adhesion, or byadjusting the fixative properties of the adhesive mechanism, or by anyother means as required.

An alternative construction of the garment separable seam 15 and closuremechanism is illustrated in cross-sectional schematics in FIGS. 5 athrough 5 c. FIG. 5 a illustrates the separable seam 15 in thepre-operative environment. It depicts an over-folded pleat 35, whichserves to conceal perforated seam margins 25. The form of the pleat inFIG. 5 a is retained by use of a temporary adhesive joint, 26 a whichmay be either continuous or intermittent in nature. The adhesive joint26 a also serves to conceal the perforated seam margins 25 providingadditional insulation, thereby preventing body heat loss via theperforations 25. In order to better retain the form of the over-foldedpleat 35, an additional optional adhesive strip 26 b is illustrated.FIG. 5 b illustrates the separable seam as deployed, having separatedthe adhesive joint 26 a the perforations 25 are revealed, allowing thegarment 10 to be sectioned and the patient 9 to be exposed as previouslydescribed. At this point, adhesive strip 26 b is still concealed withinthe remaining garment pleat. FIG. 5 c illustrates the garment 10 in thepost-operative environment with the garment closed around the patient.This configuration utilizes both of the adhesive strips 26 a, 26 bdeployed as a means of closing the garment.

The embodiment illustrated in FIG. 5 is beneficial in its simplicity,requiring only the insertion of a reduced strength fabric section 11thereby creating a seam and the addition of temporary adhesive means 26with which to conceal the separable margins 37. As previously disclosed,the preferred means for constructing the weakened element 15 of thefabric 11 is by linearly arranged perforations 25, although other meansmay be used as practicable. The temporary adhesive strip 26 a, may belocated by markings on the exterior surface 13 of the fabric 11, or bymeans of piping (not shown), affixed to the outer surface 13 of thefabric 11, or by other means as applicable. This reduces the complexityof garment construction such that the only elements which are requiredare fabric 11 and adhesive elements 26. It also paves the way for theuse of more sophisticated adhesive means which are responsive only tospecifically treated fabric types yet which do not have active viscidproperties and which would therefore be ideally suited to the hospitalenvironment.

Therefore, in FIG. 5, in the vicinity of the desired perforation 25boundaries 15, the outer surface of the garment, 13 contains a reducedstrength element in the construction of the fabric 11 which, whendislocated, allows the perforations 25 to be exposed, and, asillustrated in FIG. 5 b, creates two separate panels 17 with adjacentmargins 37 thus enabling the garb 10 to be opened as has hitherto beendescribed. The weak point 15 is preferentially constructed using reducedstrength adhesives 44, but any manner of fabric fusion, stitching oradhesive methods which create an impermanent bond, or reduced-strengthseam, may be used without departing from the spirit of the invention.

The advantages of this garment closure configuration are clear: theyallow simplification of the garment 10 construction, without therequirement for separate internal 38 or external sealing strips 44. Theconcealed nature of temporary sealing strip 26 b prevents the adhesivesurface 26 b from becoming prematurely and incorrectly affixed. Thefabric over fold 35 may be further encouraged to retain its form withinthe garment structure by virtue of surfaces which are treated such thatthey tack-bond the pleat to the interior surface 12 of the garmentfabric 11, or, alternatively, bond the fabric overfold 35 to itself onits internal surface or by any other means which achieves the requiredobjective.

After the medical, surgical, therapeutic and/or diagnostic interventionis completed, as illustrated in FIG. 5 c, the garment opening is thenclosed by opening the over fold pleat 35 and revealing the adhesivestrip 26 b which is used to re-attach the adjacent fabric panels 17,restoring garment functionality and preventing further patient heatloss. Further garment closure strength may be achieved by utilizing morethan one adhesive bonding margin, for example as illustrated in FIG. 5 cwhere adhesive strips 26 a and 26 b, act mutually to provide additionalbond strength to the garment closure thereby creating a more securebond.

Alternatively, as in simplified FIG. 6, the adhesive 44 may be re-usableand may be set directly onto the inner surface 12 of the fabric 11, ormay be particularly inserted into a groove 33 embossed into either thecellulose garment fabric 11 or, alternatively, as illustrated in FIG. 6,into an internal fabric strip 38, as desired. The inventors perceivethat inserting the adhesive in a bead format into a pre-formed channel33 which is embossed in the web 16 substrate is advantageous both inmanufacturing and deployment as it constrains the adhesive 44 topre-determined positions and orientations. This makes placement of theadhesive during manufacture more precise as it prevents the adhesive 44from encroaching on the surrounding substrates 12, 13. In addition,depending on the type of adhesive used, it may be covered with aprotective strip (not illustrated) in order to maintain its adhesivequalities or prevent premature and unwanted adhesion. Such adhesiveprotective strips are frequently used in stationery products for similarpurposes.

If a style or fabric format is selected which is incapable of beingperforated, or if it is desired to completely conceal the garmentclosure mechanism from casual observation, an alternative configurationis illustrated in FIG. 7 a through 7 c. The location of the seam 15, maybe indicated through positioning by means of a line drawn on thematerial, or piping 34, or more appropriately, twin parallel piping 34,which indicates the margins 37 (illustrated in FIG. 7 b) of adjacentfabric panel sections 17, or by any other means which provides clearindication of the position of the garment opening seams 15. Located onthe inner surface 12 of the fabric 11 and to one side of the openingseam 15 is a self-contained re-sealing strip 38. This configuration maybe considered advantageous in circumstances where the over-ridingconcern is pre-operative garment integrity, or where the appearance ofthe garment is a significant design criteria. The remainder of thefeatures illustrated in FIG. 7 are similar to those detailed in FIG. 4,however, it is desirable to manufacture the garment such that thetension on the internal fabric web 38 should preferably match thetension of the garment fabric 11 so as to provide stress relief on theopening seam 15.

FIG. 8 a illustrates one configuration a preferred embodiment of thegarment 10 as worn by a patient. This figure illustrates an embodimentof the garment 10, utilizing a segmented approach to configuring theseparable fabric strips 38, 47. In order to simplify the concept, FIG. 8a illustrates external fabric strips 47, however, it will be understoodthat internal fabric strips 38, may be equally as effective. Crosssectional depictions of internal fabric strips 38 are contained in FIGS.4, 7 and 8 d. The garb 10, as illustrated, is long sleeved withelasticated cuffs 39 at the wrist and, preferentially, some form ofheat-retentive elasticated band at the waist 39. The garment separableseams 15 are located beneath the external fabric strips 47 andcollaborate to define garment panels 17 which are of utility in themedical, surgical, therapeutic and/or diagnostic environment. Theillustrations are not intended to provide constraint or limitation onthe placement of panel seams 15 which may be of any dimension and in anylocation, as may be required.

The garment, 10 as illustrated in FIG. 8 a is divisible into segments 17as originally illustrated in FIG. 1 b, although clearly it could besegmented in other ways, as desired. However, unlike FIG. 1 b, thegarment segments' 17 outer surface 13 fabric margins 37 are eachoverlain by a narrow textile layer 47, which is affixed to the outersurface 13 of the garment material 11. If desired, in order to preventheat loss from the patient, the garment fabric layers 11 may beconfigured so as to overlap as in FIG. 8 d.

FIG. 8 a shows the outer textile layer 47 being affixed to the garmentexterior surface 13 by means of stitching 48, however, any appropriatefabric fastening method, including, but not limited to stitching,gluing, laser bonding etc., may be used as desired. The narrow textilewebbing layer 47, is equipped with perforations 25 which run along thelongitudinal axis of the webbing 47 for the purposes of providingseparation means between garment panels 17 and thus providing openingsin the garment 10. Larger diameter perforations, 27, as illustrated inexpanded drawings 8 b and 8 c, are inserted into the row ofperforations, 25. As previously disclosed, these act as both garmentpanel 17 margin 37 markers and also to provide effective limits toperforation openings, thereby more clearly defining garment panels forthe medical, surgical, therapeutic and/or diagnostic staff. Clearlythere is nothing in the design which prevents additional panel openingsbeing made as the medical, surgical, therapeutic and/or diagnosticprocedure progresses, should this become necessary and the seamconstruction is such that it may be removed in its entirety if anemergency arises. It should be noted that the attachment between theopposing margins of the web 47 differs between in its connection toadjacent margins 37 of the fabric panels 17 which comprise the garment10. On one median the stitching passes through textile layer 47, garmentfabric 11 and internal fabric strip 38, thus binding all three elementsas illustrated in sectional FIG. 8 d. On the opposing median, the outertextile layer 47 and garment fabric 11 are bound by stitching, however,the internal web 38 remains free from attachment. In this manner, oncethe adjacent garment panels 17 are separated, the internal web has adegree of freedom which allows the garment 10 to be opened and thepatient's skin 9 exposed.

FIG. 8 b and inset FIG. 8 c, illustrate isometric representations of theintersection of several panels 17 showing the detail of the webbing 47,the outer textile layer 13 and its application to the fabric panels 17.Adjacent panels 17, intersect at margins 37 which margins arecontiguously overlain by an external fabric strip 47, which ispermanently affixed to the external surface 13 of the fabric 11 alongboth margins of the strip. The external fabric strip 47 is equipped withmeans of separation 15, which are illustrated as perforations 25 and forpreference equipped with extra-large perforations 27 which act to defineand delineate panels 17 such that panel boundaries 37 can be easilyidentified.

FIG. 8 d shows a cross sectional view across A-A1 from FIG. 8 c. Itillustrates adjoining fabric panels 17 which are overlaid on their outersurface 13, by an external fabric strip 47, and lined on the innersurface 12, by an internal web 38. In the embodiment illustrated, theexternal fabric strip 47 and internal web 38 are ideally attachedthrough the garment fabric 11 along a single margin. Along the opposingmargin, the external fabric strip 47 is only attached to the fabric 11and not to the internal web 38, thereby allowing the garment panels 17to be separated. As previously disclosed, the internal web 38 ispreferentially equipped with adhesive 45 means enabling the garmentpanels 17 to be closed following treatment. Such adhesive re-attachmentsmay be protected, as illustrated, by a protective cover 46.

FIG. 8 e shows an alternative embodiment of the seam element 15 of thegarment 10 showing overlapping adjacent garment panels 17 whichconfiguration is advantageous as it minimizes patient heat loss throughthe perforated 25 section margins 37.

In summary, the illustrations and detailed description of the inventionprovide indications of some modes of construction and are not intendedto provide a constraint on the invention. For example, the seamlocations indicated in the Figures explore only a few of the potentialgarment seam configurations. There are also clearly many alternativesfor carrying out the reattachment of the garment which may incorporatealternative configurations of adhesive means and methods of enhancingthe performance of the adhesive means prior to, during and after garmentdeployment and these means are considered to be within the scope of theinvention. In a similar manner, the selection of fabric type andchemical treatment or finishing of the fabric may vary according todifferent operational, environmental or patient specific requirementsand these variations too are considered within the scope of theinvention. Equally, differential chemical or physical treatments may beapplied to longitudinal sections of the web or garment fabric in orderto create variations in adhesive characteristics or create otherconfigurations which are selected for practical, hygienic or sanitaryreasons, without departing from the spirit of the invention.

CLAUSES

CLAUSE 1: A versatile garment which is a facsimile of normal clothingand which promotes personal well-being, privacy, modesty and euthermia,for use in the hospital environment or as required in thepatient-care-giver interaction, which garment beneficially incorporatesmeans for versatile garment deconstruction prior to treatment ormonitoring allowing patient access and incorporates means forpost-treatment reconstruction of the garment in the post-treatment,diagnostic exam or monitoring environment.

CLAUSE 2: The garment according to Clause 1 which is equipped with meansfor the provision of easily removable, segmentable or detachable andre-attachable panels which re-attachable means are non-site specific,thereby conferring superior re-dimensioning and re-configurableproperties to the garment. The separable margins of the panelsbeneficially allow for selective disassembly of the garment, as required

CLAUSE 3: The garment according to Clause 1 or for use inpre-diagnostic, medical, surgical, therapeutic and/or diagnostic or anyother type or modality of intervention as required in thepatient-care-giver interaction, whether in the home, during patienttransport, outdoors, in the healthcare facility or chronic-health carefacility. Use may made in any location for any purpose deemedappropriate and these definitions are not intended to limit the scope orfurther adaptability of the invention as it becomes utilized.

CLAUSE 4: The garment according to Clause 1, which promotes a single useclean or sterile application, for use in the hospital environment or inany setting, in or out of a medical facility, as required in thepatient-care-giver interaction

CLAUSE 5: A garment, according to Clause 1, allowing for secure,appropriate and independent coverage of the upper and lower body. Thegarment may either be wholly removed or, preferentially, partiallydisassembled, in order to fulfil modality specific requirements.

CLAUSE 6: A garment, according to Clause 1, which is compatible withother health-care devices and systems, according to Clause 1 whichpromotes patient euthermia, which euthermic properties can be augmentedthrough the use of external heat sources.

CLAUSE 7: A versatile garment, according to Clause 1, which allowsaccess in the abdominal area for colostomy bags or open abdominalwounds; in the perineal area for catheterisation of the urinary system,in the back shoulder, anterior and lateral chest for telemetry andcentral lines, in the extremities (ventral aspect of wrist, dorsum ofhand or foot, ankle, groin or ante-cubital fossa for intravenous,intra-arterial and central line access, or which may be specificallyconfigured to accommodate any other intervention as may be required.Furthermore, the garment configuration is unconstrained, such thatdiagnostic specific configurations may be fabricated, allowing site orequipment specific treatment, therapeutic or diagnostic procedures to beperformed on any part of the body e.g. ultrasound examination of anabscess, Wound-Vac™ management of an open wound, mammography, etc.

CLAUSE 8: The garment of Clause 1 which is further formed from materialsand incorporating fixtures, processes and structures, such that it isnot rendered radio-opaque nor provides interference with MagneticResonance Imaging or Computer Assisted Tomography or radiography orother diagnostic modalities, or, alternatively, may contain radio opaquepanels to protect the reproductive organs.

CLAUSE 9: The garment of Clause 1 which may be modified through the useof color, pattern or markings enabling rapid patient statusidentification, enhancing the patient-care-giver process.

1. A garment as a facsimile of normal clothing for use in the hospitalenvironment or as required in the patient-care-giver interaction, whichgarment comprises means for versatile garment deconstruction prior totreatment or monitoring allowing patient access and incorporates meansfor post-treatment reconstruction of the garment in a post-treatment,diagnostic exam or monitoring environment.
 2. The garment according toclaim 1, equipped with means for the provision of easily removable,segmentable or detachable and re-attachable panels.
 3. The garmentaccording to claim 2, wherein the re-attachable means are non-sitespecific.
 4. The garment according to claim 1, having re-dimensioningand/or re-configurable properties.
 5. The garment as claimed in claim 1,having panels with separable margins allowing selective disassembly ofthe garment.
 6. The garment according to claim 1 adapted for use inpre-diagnostic, medical, surgical, therapeutic and/or diagnostic or anyother type or modality of intervention as required in thepatient-care-giver interaction, whether in the home, during patienttransport, outdoors, in the healthcare facility or chronic-health carefacility.
 7. The garment as claimed in claim 1, as a single use clean orsterile garment.
 8. The garment, according to claim 1, adapted to bewholly removable and/or partially disassembled during use.
 9. Thegarment, according to claim 1, which is adapted to accommodatehealth-care devices and systems.
 10. The garment according to claim 1,adapted to promote patient euthermia, which euthermic properties can beaugmented through the use of external heat sources.
 11. The garmentaccording to claim 1, which is adapted to allow access to the abdominalarea of a wearer.
 12. The garment according to claim 1, which is adaptedto allow access the perineal area of a wearer.
 13. The garment accordingto claim 1, which is adapted to allow access to the back shoulder and/oranterior and/or lateral chest for telemetry and central lines.
 14. Thegarment according to claim 1, adapted for access in the extremities suchas ventral aspect of wrist, dorsum of hand or foot, ankle, groin orante-cubital fossa for intravenous, intra-arterial and central lineaccess.
 15. The garment according to claim 1, configured such that thegarment configuration is unconstrained, such that diagnostic specificconfigurations may be fabricated, allowing site or equipment specifictreatment, therapeutic or diagnostic procedures to be performed on anypart of the body.
 16. The garment according to claim 15, adapted toallow ultrasound examination of an abscess and/or Wound-Vac™ managementof an open wound and/or mammography.
 17. The garment according to claim1 which is further formed from materials and incorporating fixtures,processes and structures, such that it is not rendered radio-opaque norprovides interference with Magnetic Resonance Imaging or ComputerAssisted Tomography or radiography or other diagnostic modalities. 18.The garment according to claim 1, further comprising radio opaquepanels.
 19. The garment according to claim 1, further modified throughthe use of color, pattern or markings enabling rapid patient statusidentification.